PEMF and Fractures

Abstracts of scientific studies on the use of PEMF with Fractures:A group of 83 adults with un-united fractures were examined for the effects of bone grafting and pulsed electromagnetic fields for this study. Results showed a successful healing rate of 87% in theoriginal 38 patients treated with bone grafts and PEMF for un-united fractures with wide gaps, malalignment, and synovial pseudarthrosis. Of the 45 patients that were not successfully treated with PEMF and had bone grafting, when re-treated with pulsing electromagnetic fields, achieved a 93% success rate.C.A.Bassett, et al., "Treatment of Therapeutically Resistant Non-unions with Bone Grafts and Pulsing Electromagnetic Fields," Journal of Bone Joint Surg, 64(8), October 1982, p. 1214-1220.____________________________________________________________________________Examining the effects of pulsing electromagnetic fields on 125 patients suffering from un-united fractures of the tibial diaphysis, showed a healing success rate of 87%.C.A. Bassett, et al., "Treatment of Un-united Tibial Diaphyseal Fractures with Pulsing Electromagnetic Fields," Journal of Bone Joint Surg, 63(4), April 1981, p. 511-523.____________________________________________________________________________This review article makes the following observations with respect to the use of pulsed electromagnetic fields in treating un-united fractures, failed arthrodeses, and congenital pseudarthroses. The treatment has been shown to be more than 90 % effective in adult patients.C.A. Bassett, "The Development and Application of Pulsed Electromagnetic Fields (PEMFs) for Un-united Fractures and Arthrodeses," Clin Plast Surg, 12(2), April 1985, p. 259-277.____________________________________________________________________________This double blind, placebo-controlled study examined the effects of pulsed electromagnetic fields in femoral neck fracture patients undergoing conventional therapy. Results showed beneficial effects relative to controls after 18 months of follow-up.E. Betti, et al., "Effect of Electromagnetic Field Stimulation on Fractures of the Femoral Neck. A Prospective Randomized Double-Blind Study,”Second World Congress for Electricity and Magnetism in Biology and Medicine, 8-13 June 1997, Bologna, Italy.____________________________________________________________________________Results of this double-blind study showed significant healing effects of low frequency pulsing electromagnetic fields in patients treated with femoral intertrochanteric osteotomy for hip degenerative arthritis.G. Borsalino, et al., "Electrical Stimulation of Human Femoral Intertrochanteric Osteotomies. Double-Blind Study," Clin Orthop, (237), December 1988, . 256- 263. ____________________________________________________________________________In this study, 147 patients with fractures of the tibia, femur, and humerus who had failed to benefit from surgery-received treatment with external skeletal fixation in situ and pulsed electromagnetic fields. Results indicated an overall success rate of 73 percent. Femur union was seen in 81 percent and tibia union in 75 percent.M. Marcer, et al., "Results of Pulsed Electromagnetic Fields (PEMFs) in Un-united Fractures after External Skeletal Fixation," Clin Orthop, (190), November 1984, 260-265____________________________________________________________________________This study examined the effects of extremely low frequency electromagnetic fields (1-1000 Hz, 4 gauss) on new bone fractures of female patients. Results led the authors to suggest that EMF treatment accelerates the early stages of fracture healing.O. Wahlstrom, "Stimulation of Fracture Healing with Electromagnetic Fields of Extremely Low Frequency (EMF of ELF)," Clin Orthop, (186), June 1984, . 293- 301.____________________________________________________________________________This article discusses the cases of two children with bone malunion following lengthening of congenitally shortened lower legs. Pulsed sinusoidal magnetic field treatment was beneficial for both patients.F. Rajewski & W. Marciniak, "Use of Magneto therapy for Treatment of Bone Malunion in Limb Lengthening. Preliminary Report," Chir Narzadow Ruchu Ortop Pol, 57(1-3), 1992,. 247-249.____________________________________________________________________________Results of this study found treatment induced pulsing to be beneficial in patients suffering from nonunions unresponsive to surgery.J.C. Mulier & F. Spaas, "Out-patient Treatment of Surgically Resistant Nonunions Induced Pulsing Current - Clinical Results," Arch Orthop Trauma Surg, 97(4), 1980,.293-297.____________________________________________________________________________This review article notes that the use of pulsed electromagnetic fields began in 1974, and that 250,000 nonunion patients have received the treatment since. The author argues that success rates are comparable to those of bone grafting, and that PEMF treatment is more cost-effective andfree of side effects. The FDA approved PEMF use in 1982, although it remains widely unused due to physician misunderstanding and lack of knowledge concerning the treatment.A. Bassett, "Therapeutic Uses of Electric and Magnetic Fields in Orthopedics,& quot; in D.O. Carpenter & S. Ayrapetyan, (eds.), Biological Effects of Electric and Magnetic Fields. Volume II: beneficial and Harmful Effects, San Diego: Academic Press, 1994, . 13-48.____________________________________________________________________________This 7-year study examined data on more than 11,000 cases of non-unions treated with pulsed electromagnetic fields. Results indicated an overall success rate of 75 percent.A.A. Goldberg, "Computer Analysis of Data on More than 11,000 Cases of Un-united Fracture Submitted for Treatment with Pulsing Electromagnetic Fields," Bioelectrical Repair and Growth Society, Second Annual Meeting, 20-22 September 1982, Oxford, UK, . 61.____________________________________________________________________________This study examined the effects of constant magnetic fields in patients with fractures. Results showed that magnetic exposure reduced pain and the onset of edema shortly after trauma.G.B. Gromak & G.A. Lacis, "Evaluations of the Efficacy of Using a Constant Magnetic Field in Treatment of Patients with Traumas," in I. Detlav, (ed.), Electromagnetic Therapy of Injuries and Diseases of the Support- Motor Apparatus. International Collection of Papers, Riga, Latvia: Riga Medical Institute, 1987, . 88-95.____________________________________________________________________________This review article looks at the history of pulsed electromagnetic fields as a means of bone repair. The author argues that success rates have been either superior or equivalent to those of surgery, with PEMF free of side effects and risk.C.A.L. Bassett, "Historical Overview of PEM-Assisted Bone and Tissue Healing, " Bioelectromagnetics Society, 10th Annual Meeting, 19-24 June 1988, Stamford, CT, . 19.____________________________________________________________________________Effects of different extremely low-frequency electromagnetic fields on osteoblastsThe purpose of this study was to examine the response of neonatal rat calvarial bone cells to the rectangular electromagnetic field (REMF), triangular electromagnetic field (TEMF), sinusoidal electromagnetic field (SEMF), and pulsed electromagnetic field (PEMF). The stimulatory effects of EMF were evaluated by the proliferation (methyltetrazolium colorimetric assay), differentiation (alkaline phosphatase (ALP) activity), and mineralization (area of mineralized nodules of the cells). PEMF promoted the proliferation of osteoblasts, inhibited their differentiation, and increased the mineralized nodules formation (p < 0.05).Moreover, the effects of PEMF on osteoblasts were concerned with the extracellular calcium, P2 receptor on the membrane, and PLC pathway. However, the response of osteoblasts on SEMF was only related to PLC pathway. The results suggested that the waveforms of EMF were the crucial parameters to induce the response of osteoblasts.

____________________________________________________________________________A double-blind trial of post-electromagnetic fields for delay the union of tibial fractures Electromagnetic fields significantly influence healing in tibial fractures with delayed union. A total of 45 tibial shaft fractures, all conservatively treated and with union delayed for more than 16 to less than 32 weeks were entered into this double-blind multi-center trial.

Author: WJW, Sharrard

Year: 1990

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Booktitle: JBJS (Br)

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